7.0T MRI 下组织钠离子浓度定量分析作为乳腺癌化疗反应的早期标志物：一项可行性研究。
Tissue Sodium Concentration Quantification at 7.0-T MRI as an Early Marker for Chemotherapy Response in Breast Cancer: A Feasibility Study.
机构信息
From the Institute for Clinical Molecular MRI in Musculoskeletal System, Karl Landsteiner Society, Vienna, Austria (O.Z., S.T.); Breast Health Center, Department of Obstetrics and Gynecology (A.F., E.A., C.F.S.), and High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy (L.M., M.W., S.T.), Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria; Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany (S.L., A.M.N.); and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.).
出版信息
Radiology. 2021 Apr;299(1):63-72. doi: 10.1148/radiol.2021201600. Epub 2021 Feb 16.
Background Tissue sodium concentration (TSC) is elevated in breast cancer and can determine chemotherapy response. Purpose To test the feasibility of using a sodium 23 (Na) MRI protocol at 7.0 T for TSC quantification to predict early treatment outcomes of neoadjuvant chemotherapy in breast cancer and to determine whether those quantitative values provide additional information about efficacy. Materials and Methods Women with primary breast cancer were included in this prospective study. From July 2017 to June 2018, participants underwent 7.0-T Na MRI. Multichannel data sets were acquired with a density-adapted, three-dimensional radial projection reconstruction pulse sequence. Two-dimensional tumor size and TSC were evaluated before and after the first and second chemotherapy cycle, and statistical tests were performed based on the presence or absence of a pathologic complete response (pCR). Results Fifteen women with breast cancer and six healthy women were enrolled. The mean baseline tumor size in women with a pCR was 7.0 cm ± 5.0 (standard deviation), and the mean baseline tumor size in women without a pCR was 19.0 cm ± 12.0. After the first chemotherapy cycle, women with a pCR showed a reduced tumor size of 32.9% (2.3 cm/7.0 cm), compared with 15.3% (2.9 cm/19.0 cm) in those without a pCR. The areas under the receiver operating characteristic curve for tumor size reduction after the first and second chemotherapy cycle were 0.73 (95% CI: 0.09, 0.50; = .12) and 0.93 (95% CI: 0.04, 0.60; < .001), respectively. Women with a pCR had a mean baseline TSC of 69.4 mmol/L ± 6.1, with a reduction of 12.0% (8.3 mmol/L), whereas those without a pCR had a mean baseline TSC of 71.7 mmol/L ± 5.7, with a reduction of 4.7% (3.4 mmol/L) after the first cycle. The areas under the receiver operating characteristic curve for TSC after the first and second cycles were 0.96 (95% CI: 0.86, 1.00; < .001) and 1.000 (95% CI: 1.00, < .001), respectively. Conclusion Using 7.0-T MRI for tissue sodium concentration quantification to predict early treatment outcomes of neoadjuvant chemotherapy in breast cancer is feasible, with reduced tissue sodium concentration indicative of cancer response. © RSNA, 2021
背景 组织钠浓度（TSC）在乳腺癌中升高，并可决定化疗反应。目的 测试使用 7.0-T Na 磁共振成像（MRI）方案进行 TSC 定量以预测乳腺癌新辅助化疗早期治疗结果的可行性，并确定这些定量值是否提供关于疗效的额外信息。材料与方法 本前瞻性研究纳入了原发性乳腺癌女性患者。2017 年 7 月至 2018 年 6 月，参与者接受了 7.0-T Na MRI 检查。采用密度适应的三维径向投影重建脉冲序列采集多通道数据集。在第一和第二化疗周期前后评估二维肿瘤大小和 TSC，并基于是否存在病理完全缓解（pCR）进行统计检验。结果 15 名乳腺癌女性和 6 名健康女性入组。pCR 女性的基线肿瘤大小平均值为 7.0 cm ± 5.0（标准差），无 pCR 女性的基线肿瘤大小平均值为 19.0 cm ± 12.0。在第一化疗周期后，pCR 女性的肿瘤大小缩小了 32.9%（2.3 cm/7.0 cm），而无 pCR 女性的肿瘤大小缩小了 15.3%（2.9 cm/19.0 cm）。第一次和第二次化疗周期后肿瘤大小缩小的受试者工作特征曲线下面积分别为 0.73（95% CI：0.09，0.50； =.12）和 0.93（95% CI：0.04，0.60； <.001）。pCR 女性的基线 TSC 平均值为 69.4 mmol/L ± 6.1，降低了 12.0%（8.3 mmol/L），而无 pCR 女性的基线 TSC 平均值为 71.7 mmol/L ± 5.7，第一次周期后降低了 4.7%（3.4 mmol/L）。第一次和第二次化疗周期后 TSC 的受试者工作特征曲线下面积分别为 0.96（95% CI：0.86，1.00； <.001）和 1.000（95% CI：1.00， <.001）。结论 使用 7.0-T MRI 进行组织钠浓度定量以预测乳腺癌新辅助化疗的早期治疗结果是可行的，组织钠浓度降低表明癌症有反应。 © RSNA，2021
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